Iatrogenic Acute Aortic Insufficiency Following Mitral Valve Replacement

Iatrogenic acute aortic insufficiency after heart procedures is rare and it can happen secondary to cusp entrapment, tension, laceration, or perforation. The aortic valve is located anterior and to the right of the mitral valve, which makes it susceptible to damage during mitral valve replacement or repair. We report a 62-year-old male who developed acute aortic valve insufficiency following mitral valve replacement where using an intraoperative transesophageal echocardiogram (TEE) prompted early diagnosis and management. Late diagnosis is usually associated with increased morbidity and mortality. The aortic insufficiency resulted from entrapment of the aortic valve annulus due to suture misplacement at the commissure between the left and noncoronary cusp. This case report shines the light on the importance of a thorough intraoperative TEE during cardiac surgery to early diagnose and treat any complications.